Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,790.45 / $2,747.00 / $7,920.26	Facility		$1,790.45	$2,747.00	$7,920.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,396.81 / $1,969.30 / $2,241.79	Professional		$1,396.81	$1,969.30	$2,241.79
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $854.01 / $1,697.74 / $2,552.54	Facility		$854.01	$1,697.74	$2,552.54
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,107.67 / $1,701.56 / $1,804.98	Facility		$1,107.67	$1,701.56	$1,804.98
Providence Facility/Professional Facility Modifier Low / Median / High Price $854.01 / $1,851.49 / $2,552.54	Facility		$854.01	$1,851.49	$2,552.54
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $346.77 / $346.77 / $346.77	Facility	80	$346.77	$346.77	$346.77
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $294.75 / $294.75 / $294.75	Facility	AS	$294.75	$294.75	$294.75
United Facility/Professional Facility Modifier Low / Median / High Price $376.00 / $3,290.00 / $6,216.00	Facility		$376.00	$3,290.00	$6,216.00